Socio-demographic and clinico-pathological analysis of cervical cancer patients at a tertiary care centre in South-south Nigeria

Authors

  • Justina O. Alegbeleye Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Solomon Nyeche Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
  • Merry A. Jaja Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231517

Keywords:

Cervical cancer, Clinical profile, Demography, Pathology, Port Harcourt

Abstract

Background: Cervical cancer is a significant public health burden in low- and middle-income countries where access to screening and treatment is limited. It is the leading cause of cancer deaths in women in Africa, often due to late presentation and diagnosis. Aim of this study was to determine the socio-demographic and clinical profile of cervical cancer patients and their relationship with tumour related factors.

Methods: This was a retrospective review of all cases of histologically confirmed cervical cancer patients managed at the University of Port Harcourt Teaching Hospital, Port Harcourt, over a 5-year period. A data collection form was used to obtain socio-demographic characteristics and clinical profile from the patients’ case records.

Results: The mean age of the women was 53.3±8 years, with the highest prevalence in the 55-64 age group 26 (33.3%). Majority 59 (74.4%) of the women were multiparous, and 50 (64.1%) were married. Most 32 (41%) had primary education and about one-third 24 (30.8%) were farmers. The most common clinical features were vaginal bleeding, foul-smelling vaginal discharge, pelvic pain, and weight loss 46 (59%), while squamous cell carcinoma (SCC) was the predominant histological type 56 (71.8%). Only 9 (11.5%) had any form of screening for early detection of cervical cancer. Most 31 (39%) of the patients presented with stage III disease, with a median hemoglobin level of 6.8 (2.3) g/dl before treatment. About two-third 54 (69%) of them had severe anaemia. There was significant association between marital status and histological type (X2 = 42.096, p-value = 0.001).  Use of oral contraceptive pills (X2 = 7.602, p-value =0.04) and menopausal state (X2 = 6828, p-value =0.05), were significantly associated with cancer stage.

Conclusions: There is an urgent need to scale up advocacy for regular screening for cervical cancer and vaccination, to ensure increased awareness, early detection, and prevent the progression of early disease.

 

References

Avidime S, Ahmed SA, Oguntayo A, Abu TO, Ndako JA. Pattern of cervical dysplasia among women of reproductive age in Zaria, Northern Nigeria. J Med Trop. 2014;16(2):52-5.

Kaverappa V, Prakash B, Kulkarni P, Renuka M. Sociodemographic profile of patients with cervical cancer in a tertiary-care cancer hospital in Mysuru, Karnataka. Int J Med Sci Public Health. 2015;4(9):1187-90.

Musa J, Nankat J, Achenbach CJ, Shambe IH, Taiwo BO, Mandong B, et al. Cervical cancer survival in a resource-limited setting-North Central Nigeria. Infect Agent Cancer. 2016;11(1):1-7.

Dahiya N, Bachani D, Acharya AS, Sharma DN, Gupta S, Haresh KP. Socio-Demographic, Reproductive and Clinical Profile of Women Diagnosed with Advanced Cervical Cancer in a Tertiary Care Institute of Delhi. J Obstet Gynecol India. 2017;67(1):53-60.

Jain A, Ganesh B, Bobdey S, Sathwara J, Saoba S. Sociodemographic and clinical profile of cervical cancer patients visiting in a tertiary care hospital in India. Indian J Med Paediatr Oncol. 2017;38(3):291-5.

Umate P, Thengal DS, Kurdukar D. Study of Clinical Profile of cervical cancer patients: a hospital based study. Int J Reprod Contraception Obstet Gynecol. 2017;6(11):4873-8.

Ilesanmi R, Kehinde D. Pattern of Utilization of Cervical Cancer Screening Services among Female Sex Workers in Some Selected Brothels in Abuja, Nigeria. Asia-Pacific J Oncol Nurs. 2018;5(4):415-20.

Awofeso O, Roberts AA, Salako O, Balogun L, Okediji P. Prevalence and pattern of late-stage presentation in women with breast and cervical cancers in Lagos University Teaching Hospital, Nigeria. Niger Med J. 2018;59(6):74-9.

Suralkar T, Agrawal V, Shewalka B. Clinical and Socio-Demographic Profile of Cervical Patients. Int J Sci Res. 2019;32(7):53-4.

Parvathi M, Guru Prasad PG, Naldeega R, Lekha GD. Study of Clinical Significance of Pap Smear in STD Clinics. J Evol Med Dent Sci. 2015;4(100):16558-62.

Makena Frida K, Carole Atieno WM, Habtu M. Socio-demographic factors associated with advanced stage of cervical cancer at diagnosis in Kenyatta National Hospital, Kenya: a cross sectional study. J Cancer Sci Ther. 2017;9(7):554-61.

Mathew A, George PS, Ramadas K, Mathew BS, Kumar A, Roshni S, et al. Socio-demographic factors and stage of cancer at diagnosis: A population-based study in South India. J Glob Oncol. 2019;(5):1-10.

Williams J, Rakovac I, Victoria J, Tatarinova T, Corbex M, Barr B, et al. Cervical cancer testing among women aged 30 - 49 years in the WHO European Region. Eur J Pub Health. 2021;31(4):884-9.

Wojtyla C, Janik-Koncewicz K, La Vecchia C. Cervical cancer mortality in young adult European women. Eur J Cancer. 2020;126:56-64.

Wojtyla C, Ciebiera M, Kowalczyk D, Panek G. Cervical Cancer Mortality in East-Central European Countries. Int J Environ Res Pub Heal. 2020;17(13):1-11.

Torre LA, Islami F, Siegel RL, Ward EM, Jemal A. Global Cancer in women: Burden and Trends. Cancer Epidemiol Biomark Prev. 2017;26(4):444-57.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: Cancer J Clin. 2018;68(6):394-424.

Joseph A, Olatosi B, Haider MR, Adegboyega BC, Lasebikan NN, Aliyu UM, et al. Patient’s Perspective on the Impact of COVID-19 on Cancer Treatment in Nigeria. JCO Glob Oncol. 2022;(8):e2100244.

Olubodun T, Balogun MR, Odeyemi AK, Odukoya OO, Ogunyemi AO, Kanma-Okafor OJ, et al. Barriers and recommendations for a cervical cancer screening program among women in low-resource settings in Lagos Nigeria: a qualitative study. BMC Public Health. 2022;22(1):1906.

Ilevbare OE, Adegoke AA, Adelowo CM. Drivers of cervical cancer screening uptake in Ibadan, Nigeria. Heliyon. 2020;6(3):e03505.

Thulaseedharan JV, Malila N, Hakama M, Esmy PO, Cheriyan M, Swaminathan R, et al. Socio-demographic and Reproductive risk factors for cervical cancer - a large prospective cohort study from rural India. Asian Pac J Cancer Prev. 2012;13(6):2991-5.

Adegeye YA, Ogunbiyi JO, Omigbodun AO. Trends in The Patterns of Cancers in Nigerian Women Over Five Decades. Afr J Biomed Res. 2020;23(1):105-9.

Goddy B, Kennedy NT, Michael O. Profile, and retrospective analysis of the use of preventive strategies in patients with cervical cancer in South-South Nigeria. Niger Med J. 2015;56(2):109-12.

Umezulike AC, Tabansi SN, Ewunonu HA, Nwana EJ. Epidemiological characteristics of carcinoma of the cervix in Federal capital Territory of Nigeria. Niger J Clin Pract. 2007;10(2):143-6.

Kivaju RU. Clinical profile and presentation of cervical cancer patients and its relationship with common histological type at Mbeya zonal referral hospital. University of Dodoma; 2019.

Arechkik A, Lahlou L, Obtel M, Kharbach A, Razine R. Cervical cancer in Morocco: A systematic review. Rev Epidemiol Sante Publique. 2022;70(5):230-42.

Kuguyo O, Tsikai N, Muradzikwa SC, Mhandire K, Nhachi C, Magwali T, et al. Clinical and Demographic Characteristics of cervical cancer patients presenting at Parirenyatwa Hospital, Zimbabwe. Afr J Reprod Health. 2021;25(6):100-10.

Gao Y, Ma JL, Gao F, Song LP. The evaluation of older patients with cervical cancer. Clin Interv Aging. 2013;8:783-8.

Arechkik A, Lahlou L, Obtel M, Kharbach A, Razine R. Cervical cancer in Morocco: A systematic review. Rev Epidemiol Sante Publique. 2022;70(5):230-42.

Sawaya GF, Kulasingam S, Denberg TD, Qaseem A. Cervical cancer screening in average-risk women: best practice advice from the Clinical Guidelines Committee of the American College of Physicians. Annals Int Med. 2015;162(12):851-9.

Sharma A, Kulkarni V, Bhaskaran U, Singha M, Mujtahedi S, Anshul Chatrathal A, et al. Profile of cervical cancer patients attending Tertiary Care Hospitals of Mangalore, Karnataka: A 4-year retrospective study. J Nat Sci Biol Med. 2017;8(1):125-9.

Shrivastav KD, Taneja N, Das AM, Rana S, Ranjan P, Singh H, et al. Socio-demographic and Clinico-pathological Profile of Cervical Cancer Patients at a Tertiary Care Centre in New Delhi: A Five-Year Retrospective analysis. Indian J Comm Health. 2021;33(4):634-9.

Hassan M, Nigar T. Socio-Environmental Co-Factors Associated with Cervical Cancer in Bangladesh. Sch Int J Obstet Gynecol. 2021;4(3):58-62.

Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35-year population-based analysis. J Women's Health. 2012;21(10):1031-7.

Puranik A, Shreenidhi SM, Rai SN. Spatial evaluation of prevalence, pattern, and predictors of cervical cancer screening in India. Public Health. 2020;178:124-36.

Neha EL, Kondakasseril NR. Socio-demographic, reproductive and clinical profile of women diagnosed with cervical cancer in a tertiary care center in middle Kerala. Int J Community Med Public Health. 2017;4(6):2112-7.

Usman MA, Otene SA. Clinicopathologic Features of Cervical Cancer Patients seen in a Comprehensive Cancer Centre in North-Western Nigeria. Open J Med Res. 2021;2(1):56-65.

Preethi A, Latha KVS, Kumar SS, Kumar ES. Clinical and socio-demographic profile of cervical cancer patients visiting a tertiary care hospital in India. Med Pulse Int Gynaecol. 2020;15(3):27-31.

Gaikwad SL, Valand AG, Agarwal NU. Clinico-histopathological analysis of lesions of uterine cervix in Ambejogai city of Maharashtra: A 2-year study at tertiary level hospital. J Diagn Pathol Oncol. 2016;1(2):32-5.

Azeez OA, Laima CH, Yahaya UR, Onwuachi E, Lawan, Farouk HU. Clinico-pathological analysis of cervical cancer in Gombe, Northeast Nigeria; a ten-year retrospective study. J Med Sci Clin Res. 2020;8(3):691-5.

Ononogbu U, Almujtaba M, Modibbo F, Lawal I, Offiong R, Olaniyan O, et al. Cervical cancer risk factors among HIV-infected Nigerian women. BMC Public Health. 2013;13:582.

Memiah P, Mbuthia W, Kiiru G, Agbor S, Odhiambo F, Ojoo S, et al. Prevalence and risk factors associated with precancerous cervical cancer lesions among HIV-infected women in resource-limited settings. AIDS Res Treat J. 2012;13:537-43

Gierisch JM, Coeytaux RR, Urrutia RP, Havrilesky LJ, Moorman PG, Lowery WJ, et al. Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: a systematic review. Cancer Epidemiol Biomarkers Prev. 2013;22(11):1931-43.

Bruni L, Albero G, Serrano B, Mena M, Collado JJ, Gómez D, et al. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Nigeria. Summary Report. 2021:12-14.

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Published

2023-05-26

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Original Research Articles